A lonely planet: time to tackle loneliness as a public health issue

Ding, Ding; Eres, Robert; Surkalim, Daniel L

doi:10.1136/bmj.o1464

Cited by 8 publications

(5 citation statements)

References 6 publications

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“…There are growing calls from researchers and policy makers to redefine loneliness and SI as a public health issue, and to move towards a more transdisciplinary, systems-based approach [16]. Approaching the issues of loneliness and SI through the social-ecological lens allows for a more comprehensive and systematic analysis of the factors that influence loneliness and SI in older people.…”

Section: Introductionmentioning

confidence: 99%

Social-ecological factors influencing loneliness and social isolation in older people: a scoping review

Meehan,

Grunseit,

Condie

et al. 2023

BMC Geriatr

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There are growing calls from researchers and policy makers to redefine loneliness and social isolation (SI) as public health issues, and to move towards a transdisciplinary, systems-based approach, due to their association with significant health risks, particularly in older people. Research about loneliness and SI in older people has typically adopted a narrow focus, evaluating effects of individual and inter-personal factors on these experiences. Less is known about the community and societal influences that may be used to inform public health interventions. We conducted a scoping review applying Joanna Briggs Institute methodology and the social-ecological model framework in order to: i) identify the available evidence for the influence of the community and societal factors on loneliness and SI as experienced by older people; ii) examine how quantitative research about community- and societal-level factors of loneliness and SI in the older population is conducted; and iii) identify current knowledge gaps in relation to the use of the social-ecological model in this area. A total of 52 articles from 30 countries met the inclusion criteria, including 33 observational studies, primarily cross-sectional (88%), and 19 interventions, mostly (89%) pre-post evaluations. The majority of included articles measured loneliness only (n = 34, 65%), while 11 measured both loneliness and SI (21%). To measure these outcomes validated scales were frequently used. Eighteen community/societal factors were investigated in relation to loneliness and/or SI, most commonly neighbourhood safety, access to public third-places and cultural practices. Three societal-level interventions were found: two campaigns to reduce ageism and one which explored the impact of free public transport. Community-based interventions were either educational or enlisted volunteers to foster connections. There is a need for longitudinal studies to better understand the mechanisms through which community- and societal- level factors affect loneliness and SI, which in turn will guide interventions that utilise the social-ecological framework for these issues.

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Section: Introductionmentioning

confidence: 99%

Social-ecological factors influencing loneliness and social isolation in older people: a scoping review

Meehan,

Grunseit,

Condie

et al. 2023

BMC Geriatr

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“…Greater distinction should be made between these two concepts in public health surveillance and benchmarking. Chronic loneliness affects public health and needs to be addressed systematically and comprehensively as a public health issue ( Ding et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Have Middle-Aged and Older Americans Become Lonelier? 20-Year Trends From the Health and Retirement Study

Surkalim

Clare

Eres

et al. 2023

The Journals of Gerontology: Series B

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Objectives Despite media and public dialog portraying loneliness as a worsening problem, little is known about how the prevalence of loneliness has changed over time. Our study aims to identify (a) temporal trends in episodic and sustained loneliness (lonely in 1 wave vs consistently lonely in 3 consecutive waves); (b) trends across sociodemographic subgroups by sex, race/ethnicity, birth cohort, education, employment status, marital status, and living alone; and (c) longitudinal predictors of loneliness in middle-aged and older Americans (≥50 years). Methods Based on Waves 3 (1996) to 14 (2018) of the Health and Retirement Study (n = 18,841–23,227), we conducted a series of lagged mixed-effects Poisson regression models to assess trends of episodic and sustained loneliness in the overall and sociodemographic subgroup samples (by sex, race/ethnicity, birth cohort, education, employment, relationship, and living alone status). To examine the predictors of episodic and sustained loneliness, we used a multivariate mixed-effects Poisson regression model with all sociodemographic variables entered into the same model. Results Episodic loneliness prevalence decreased from 20.1% to 15.5% and sustained loneliness from 4.6% to 3.6%. Trends were similar across most subgroups. Males, Caucasians, those born in 1928–1945, with university education, working, married/partnered, and those not living alone reported lower episodic and sustained loneliness, although associations with sustained loneliness were stronger. Discussion Contrary to common perceptions, loneliness has decreased over 20 years of follow-up in middle-aged and older Americans. Several sociodemographic subgroups have been identified as having a higher risk of loneliness, prompting targeted public health attention.

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“…Policies that impact social interactions and dining experiences in LTC should aim to balance physical safety with meaningful mealtime experiences and resident well-being. In fact, social isolation and loneliness are recognized by many as critical public health issues (Ding, Eres & Surkalim, 2022), which should not be ignored in the face of another public health crisis, such as a pandemic. Safe visitation policies to facilitate family involvement at mealtimes during future pandemics or outbreaks is one area of policy that should be further developed (Low et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Navigating Mealtimes to Meet Public Health Mandates in Long-Term Care During COVID-19: Staff Perspectives

Dakkak,

Wu,

Trinca

et al. 2023

Journal of Long Term Care

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Context: Mealtimes in long-term care (LTC) settings play a pivotal role in the daily lives of residents. The COVID-19 pandemic and the required precautionary infection control mandates influenced many aspects of resident care within LTC homes, including mealtimes. Limited research has been conducted on how mealtimes in LTC were affected during the pandemic from staff perspectives.Objective: To understand the experiences of LTC staff on providing mealtimes during the pandemic.Methods: Semi-structured telephone interviews were conducted with 22 staff involved with mealtimes between February and April 2021. Transcripts were analysed using interpretive description.Findings: Three themes emerged from the analysis: (1) recognizing the influence of homes' contextual factors. Home size, availability of resources, staffing levels and resident care needs influenced mealtime practices during the pandemic; (2) perceiving a compromised mealtime experience for residents and staff. Staff were frustrated and described residents as being dissatisfied with mealtime and pandemic-initiated practices as they were task-focused and socially isolating and (3) prioritizing mealtimes while trying to stay afloat. An 'all hands-on deck' approach, maintaining connections and being adaptive were strategies identified to mitigate the negative impact of the mandates on mealtimes during the pandemic.Limitations: Perspectives were primarily from nutrition and food service personnel.Implications: Overly restrictive public health measures resulted in mealtime practices that prioritized tasks and safety over residents' quality of life. Learning from this pandemic experience, homes can protect the relational mealtime experience for residents by fostering teamwork, open and frequent communication and being flexible and adaptive.

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A lonely planet: time to tackle loneliness as a public health issue

Cited by 8 publications

References 6 publications

Social-ecological factors influencing loneliness and social isolation in older people: a scoping review

Social-ecological factors influencing loneliness and social isolation in older people: a scoping review

Have Middle-Aged and Older Americans Become Lonelier? 20-Year Trends From the Health and Retirement Study

Navigating Mealtimes to Meet Public Health Mandates in Long-Term Care During COVID-19: Staff Perspectives

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